NUR 170-171 COMPREHENSIVE EXAM 3:
FLUID, ELECTROLYTES,
PERIOPERATIVE, AND PAIN
MANAGEMENT QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which EKG change should
the nurse expect to see?
A. Prominent U waves
B. ST segment depression
C. Tall, peaked T waves
D. Widened QRS complex with flat P waves
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves initially. As
levels rise further, the QRS widens and P waves may disappear.
2. A nurse is caring for a patient with metabolic acidosis. Which compensatory mechanism
should the nurse observe?
A. Kussmaul respirations (deep, rapid breathing)
B. Hypoventilation to retain CO2
,C. Increased renal excretion of bicarbonate
D. Decreased heart rate and blood pressure
Answer: A
Conceptual Explanation: In metabolic acidosis, the lungs compensate by blowing off
excess CO2 through deep, rapid breathing known as Kussmaul respirations.
3. Which of the following is the most appropriate nursing intervention for a patient with a
serum sodium of 152 mEq/L?
A. Administer 0.45% Sodium Chloride IV
B. Restrict fluid intake to 1000 mL/day
C. Administer 3% Sodium Chloride IV
D. Encourage the consumption of canned soups
Answer: A
Conceptual Explanation: Hypernatremia requires the administration of hypotonic
solutions (like 0.45% NS) to gradually lower sodium levels and rehydrate cells.
4. A patient is scheduled for surgery. Who is legally responsible for obtaining informed
consent?
A. The scrub nurse
B. The circulating nurse
C. The surgeon
, D. The anesthesiologist
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure, risks,
and benefits. The nurse’s role is to witness the signature and verify the patient’s
understanding.
5. During surgery, a patient develops tachycardia, muscle rigidity, and a temperature of 104 F.
Which medication should the nurse prepare?
A. Naloxone
B. Epinephrine
C. Atropine sulfate
D. Dantrolene sodium
Answer: D
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening anesthetic complication. Dantrolene is the skeletal muscle relaxant used for
treatment.
6. A postoperative patient reports sudden chest pain and dyspnea. The nurse notes a heart
rate of 110 bpm and oxygen saturation of 88%. What is the priority action?
A. Obtain an EKG
B. Apply oxygen and notify the Rapid Response Team
FLUID, ELECTROLYTES,
PERIOPERATIVE, AND PAIN
MANAGEMENT QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which EKG change should
the nurse expect to see?
A. Prominent U waves
B. ST segment depression
C. Tall, peaked T waves
D. Widened QRS complex with flat P waves
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves initially. As
levels rise further, the QRS widens and P waves may disappear.
2. A nurse is caring for a patient with metabolic acidosis. Which compensatory mechanism
should the nurse observe?
A. Kussmaul respirations (deep, rapid breathing)
B. Hypoventilation to retain CO2
,C. Increased renal excretion of bicarbonate
D. Decreased heart rate and blood pressure
Answer: A
Conceptual Explanation: In metabolic acidosis, the lungs compensate by blowing off
excess CO2 through deep, rapid breathing known as Kussmaul respirations.
3. Which of the following is the most appropriate nursing intervention for a patient with a
serum sodium of 152 mEq/L?
A. Administer 0.45% Sodium Chloride IV
B. Restrict fluid intake to 1000 mL/day
C. Administer 3% Sodium Chloride IV
D. Encourage the consumption of canned soups
Answer: A
Conceptual Explanation: Hypernatremia requires the administration of hypotonic
solutions (like 0.45% NS) to gradually lower sodium levels and rehydrate cells.
4. A patient is scheduled for surgery. Who is legally responsible for obtaining informed
consent?
A. The scrub nurse
B. The circulating nurse
C. The surgeon
, D. The anesthesiologist
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure, risks,
and benefits. The nurse’s role is to witness the signature and verify the patient’s
understanding.
5. During surgery, a patient develops tachycardia, muscle rigidity, and a temperature of 104 F.
Which medication should the nurse prepare?
A. Naloxone
B. Epinephrine
C. Atropine sulfate
D. Dantrolene sodium
Answer: D
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening anesthetic complication. Dantrolene is the skeletal muscle relaxant used for
treatment.
6. A postoperative patient reports sudden chest pain and dyspnea. The nurse notes a heart
rate of 110 bpm and oxygen saturation of 88%. What is the priority action?
A. Obtain an EKG
B. Apply oxygen and notify the Rapid Response Team
